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CITY OF FEDERAL WAY
33530 First Way South MECHA�,-pI .. smPERMIT
Federal Way, WA 93003 Mechanical Inspection Requests 253-661-4140
253-661-4000
s
ADDRESS:30404 10TH AVE: S
NO.: 091900-0245
PROJECT DESCRIPTION. -HVAC - INSTALLING NEW GAS FIREPLACE
�= OWNERCONTRACTOR
DAN FORWARD COLELLO ENTERPRISES
30404 10TH AVE S 11314 SE 162ND ST
FEDERAL WAY WA 98003 RENTON WA 98055
253-839-6503 425.468.6111 10
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PROJECT VALUATION 1500 . .z
FUEL TYPES.:GAS ELE FANS........ " BOIL SpApR _
GAS PIPING.: 20 ft HOOD....<....�:`` Q
FURN<100K..: 0 DUCT4,,%
a
GAS HWT..... 0 WOOD SZ0VE-$-,,,_..
CONY BURNER: 0 FURN)1OOK ...`: 0 30 50 ., 0
BBQ...,..... 0 MISC.- .......: 0 X50+Tff .. 0
GAS DRYER..: 0 AIR HANDLING UNIT L TANKS------
RANGE......: 0 <:10,000 CF VE GROU : ' 0
GAS LOGS...: 1 > 1011 Ck 0 NDERG .: 0
Does the wat upply s toVugh-*
sur etion Device or ckj
Inspection R DatXECH0 Date
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PERMIT NO: MEC99-0253
ISSUED: 07/22/99
FC2
EXPIR,JJW1117100
MAY. TAX RATE = 8.25 ***
MECH PERMIT FEE $ 54.00
TOTAL FEES $ 54.00
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Yes ( ) No (If °Yes° then water expansion tank is required on Hot Water Tank)
pas Piping Date
PERMITS EXPIRE 180 DA ISSUANCE IF NO MORK IS STARTED.
I CERTIFY THE IMF I FURNISHED BY HE IS TRUE AND CORRECT TO THE BEST OF NY KMOMLEDGE AND THE APPLICABLE CITY OF FEDERAL MAY REQUIREMENTS MILL BE NET.
OWNER OR AGENT DATE ` 7 Z Z 19 _
FILE COPY
BUIIAING DIVISION
Name (F,M,Q
Address
City
33530 First Way South
E.TZAL
FF*r—o.,
Contact Person
Day Phone
Federal Way, WA 98003
Fax
Expiration Date
Verified ❑ Yes ❑ No
(253)
_ _
Fax (253) 661-4129
"APPLICATION
FOR BUILDING
PERMIT
�,J"�,jJ
'LEASE PT
APPLICATION #
>. Site address
Lj
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Tenant name P
9
Lot #
Assessor's Tax #
Building Owner's Name
�&r o
Address
614Tv
6 Lk ?6
A) (
city R& W State #j
Zip
lPhone
Name (F,M,Q
Address
City
State
Zi
Contact Person
Day Phone
Other Phone
Fax
Federal Wav Busine-am Lir_ense #
I
Company Name
Address a t q S�
city 42
State
zip qq Ogg
Contact Person
a
PhoneZ5
Fax Z2 39
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
Name
Address
City
State
Zip
Contact Person
Phone
Fax
LEGAL DESCRIPTION
Contractor NameKip v; ex (®� / l ® I Address s )q ,t S 14 Z r
Contactt, I� 1/1Phone L461 �- CR I f r Fax -z 3 S T •35Y
License # C.0 `V iE L n I C� VAk/ Expiration Date - I Verified ❑ Yes ❑ No
.................... .....
Contractor NaQte
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Data
Verified ❑ Yes ❑ No
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.....................................................................................
Water Closets
Sinks.
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains
Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I am authorized by the owner of
the above premises to perform the work for which permit application is made. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenses, and
attorneys' fees incurred in investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only
where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of this application.
Yowher/Agent:
�� E Date:
Bmau .AE
REVISED 6116M
19 ')0;1'a0&
'eITY OF FEDERfAl- WAY PERMIT NO: MEC99-0253
33530 First Way South MECHANICAL PERMIT ISSUED: 07/22/99
Federal Way, WA 98003 Mechanical Inspection Requests 253-661-4140 13Y: FC2
2534-661-4000 EXPIRES: 01/17/00
ADI)RESS:30404 tom AVE S
NO.: 1091900 -0245
PROJECT' DESCRIPT ION: HVAC - INSTALLING NEW 6AS FIREPLACE
OWNERG:ltl CONTRACTOR
LENDER ........
MR FORWARD
COLILLO ENTERPRISES—*'N
30404 10111 AVE S
11314 SE 1620D St
FEDERAL WAY WA 98003
RENTON WA 98055
253-839-6503
425,468.6111
COLEL141511W
.......
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................ ...................
S" Commonts, Pirm !.tsr
tKA114i'(00f 17r wo ffmilac SALES
TAX FOR PROJECTS WITHIN 11F. City
or FLIEW WAY. TAX RATE
8.25 SU
PROJECT VALUATION
1500
FEES:
rUEL TYPES,:GAS
ELE FANS........
0
IWILEK MIMPP I
MECH PERMIT FEE
S 54.00
GAS PIPING,: 20
ft HOOD....... .. :
1
0-3 lfN....
FUR0<100t..: 0
NK I w0fit .....
a
?-15 TON—.: Q
GAS HNT..... 0
WOOD slofts
0
1S-;30'7011.... 11
CORY BURNER: o
FURRAOOY._.:
30-50
BBQ ........ : 0
MISC .......
0
504 TO# ......
GAS DRYER..: 0
AIR HARDLIK UNITS
FULL MKS -
RAKE ...... 0
<:10,000 0'":
0
A90i i 11 qioflvqi: 0
GAS LOGS...: I
> 10,000 CFM:
0
0
TOTAL FEES
E 54.00
IX08::..WaA ..... ....... ... vA .... .......... ............ 1- - K ........ ...... #f ..... . ... W...% ...... tY ......... W..A ... v....
Does the vatei supply systes contain a Pressure Reduction Device or (beck valve? Yes No (If *Yes* then nater expansion tank is required on Not Water tank)
Inspection Record: Mechanical Rough -in Date Gas Piping Dai' 7 -Z3 -moi 5
MECHANICAL FINAL Date
.......r= .... .............
PERMITS EXPIK IIIII BAYS OUR ISSUANCE IF 00 Vogt Is STARTED.
I CERTIFY IRL INfORNA114N FURNISHER ly HE is IRK AIR CORRECT 10 fly ZEST Of NY 0NUM AD TK APALICAJLE CITY OF FEDERAL WAY RIOPIRLAILKS WILL K NET.
Oz
(mm OR al DATE
FIELD COPY